OrganizationActive
Great Lakes Eye Consultants PLC
NPI 1164552972 · Ophthalmology Physician · Traverse City, MI
Provider details
- NPI number
- 1164552972
- Entity type
- Organization
- Primary specialty
- Ophthalmology PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Peter Fedor, Owner(231) 947-1690
- License
- 4301061885 (MI)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
872 Munson Ave
Suite B
Traverse City, MI 49686
Phone: (231) 947-1690
Fax: (231) 947-1692
Street-level locationGet directions
Mailing address
Po Box 308
Acme, MI 49610-0308
Registry dates
- Enumerated
- 2007-03-07
- Last updated
- 2018-05-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.